Compliance to Different Exercise-Training Protocols in Individuals with Chronic Obstructive Pulmonary Disease

Rationale: Current guidelines for pulmonary rehabilitation suggest high-intensity exercise training for patients with chronic obstructive pulmonary disease (COPD). However, compliance to this type of training is problematic. Alternative approaches, such as training at the ventilatory threshold and interval training, have been proposed as easier to comply with. The objectives of this study were to: 1) compare patient compliance to three exercise-training protocols: continuous training at high-intensity (CTHI), continuous training at the ventilatory threshold (CTVT), and interval training (IT); 2) determine if a relationship exists between exercise compliance and baseline self-efficacy in COPD patients. Methods: Subjects were randomly assigned to one of the protocols and trained on a cycle ergometer three times per week for 12 weeks. Compliance to the training protocol was measured by attendance and compliance rates to the prescribed intensity. Compliance data were obtained through data tracking technology allowing second-by-second recording of exercise-training sessions. Self-efficacy was measured using the Self-Efficacy Scale. Results: Thirty-six subjects with moderate to severe COPD participated in the study. Attendance rates did not differ significantly between groups (Mean SD: 70 ± 33% for CTHI, 82 ± 17% for CTVT, 63 ± 35% for IT, p = 0.229). Mean compliance rates were 85.6 ± 15.0 % for CTHI, 84.1 ± 15.1 % for CTVT, and 52.0 ± 41.8 % for IT (p=0.07). Self-efficacy did not correlate with mean attendance or mean compliance to the prescribed intensity. Conclusion: The present study suggests that IT may be associated with lower compliance rates than CTHI and CTVT